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Single-fraction stereotactic body radiation therapy and sequential gemcitabine for the treatment of locally advanced pancreatic cancer.
- Source :
-
International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2011 Sep 01; Vol. 81 (1), pp. 181-8. Date of Electronic Publication: 2011 May 05. - Publication Year :
- 2011
-
Abstract
- Purpose: This Phase II trial evaluated the toxicity, local control, and overall survival in patients treated with sequential gemcitabine and linear accelerator-based single-fraction stereotactic body radiotherapy (SBRT).<br />Methods and Materials: Twenty patients with locally advanced, nonmetastatic pancreatic adenocarcinoma were enrolled on this prospective single-institution, institutional review board-approved study. Gemcitabine was administered on Days 1, 8, and 15, and SBRT on Day 29. Gemcitabine was restarted on Day 43 and continued for 3-5 cycles. SBRT of 25 Gy in a single fraction was delivered to the internal target volume with a 2- 3-mm margin using a nine-field intensity-modulated radiotherapy technique. Respiratory gating was used to account for breathing motion. Follow-up evaluations occurred at 4-6 weeks, 10-12 weeks, and every 3 months after SBRT.<br />Results: All patients completed SBRT and a median of five cycles of chemotherapy. Follow-up for the 2 remaining alive patients was 25.1 and 36.4 months. No acute Grade 3 or greater nonhematologic toxicity was observed. Late Grade 3 or greater toxicities occurred in 1 patient (5%) and consisted of a duodenal perforation (G4). Three patients (15%) developed ulcers (G2) that were medically managed. Overall, median survival was 11.8 months, with 1-year survival of 50% and 2-year survival of 20%. Using serial computed tomography, the freedom from local progression was 94% at 1 year.<br />Conclusion: Linear accelerator-delivered SBRT with sequential gemcitabine resulted in excellent local control of locally advanced pancreatic cancer. Future studies will address strategies for reducing long-term duodenal toxicity associated with SBRT.<br /> (Copyright © 2011 Elsevier Inc. All rights reserved.)
- Subjects :
- Adenocarcinoma mortality
Adenocarcinoma pathology
Aged
Aged, 80 and over
Combined Modality Therapy methods
Combined Modality Therapy mortality
Deoxycytidine administration & dosage
Deoxycytidine adverse effects
Drug Administration Schedule
Feasibility Studies
Female
Humans
Male
Middle Aged
Pancreatic Neoplasms mortality
Pancreatic Neoplasms pathology
Prospective Studies
Radiotherapy Dosage
Gemcitabine
Adenocarcinoma drug therapy
Adenocarcinoma surgery
Deoxycytidine analogs & derivatives
Pancreatic Neoplasms drug therapy
Pancreatic Neoplasms surgery
Radiosurgery methods
Subjects
Details
- Language :
- English
- ISSN :
- 1879-355X
- Volume :
- 81
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International journal of radiation oncology, biology, physics
- Publication Type :
- Academic Journal
- Accession number :
- 21549517
- Full Text :
- https://doi.org/10.1016/j.ijrobp.2010.05.006